It said more guidance should be given to responsible officers (ROs) about how to deal with such cases.

In its response to the HSC report, the DoH agreed that it must be clear to ROs when a doctor's practice falls below the expected level and when fitness-to-practise procedures should be triggered.

It said: ‘The department also considers there is a need for guidance about the processes that will be in place when a responsible officer is unable to make a positive recommendation about revalidation.

‘Officials will be working with the GMC to ensure that this guidance is in place before the first recommendations are made.’

But the DoH disagreed with MPs claims that revalidation does not give enough thought to how ‘potentially dangerous’ doctors will be identified through the process.

It said revalidation provides a ‘positive affirmation’ of a doctor’s fitness to practise.

But it said enhanced systems of appraisal, clinical governance and responsible officers must be robust enough to identify and tackle poor performance at an early stage.

It said: ‘This will ensure that, where possible, any performance or practice that falls short of the expected standard can be improved.

‘However, in those cases where improvement is not possible it will ensure that patients are not put at risk while the concerns are investigated and referred to the GMC.’